Comparison of epidural morphine and morphine combined with ketaming inpostoperative patient contralled anaigesia

Objective: To discuss the effect of epidural morphine and morphine combined with ketamine in PECA, and of ketamine effects on analgesia and side effects of morphine. Methods: 40 patients ASA grade 1～2, under subarachnoid combined with epidural anaesthesia for selective gynaecological surgery were randomly assigned into two groups, morphine group (M) and morphine/ketamine group (KM). At the end of operation, a GRASEBY9300 PCA was connected to the epidural catheter. Analgesic solution contained morphine 20mg in group M and morphine 10mg +ketamine 100mg in group KM. The patients were followed up at 4, 8, 12, 24h after operation and first pressing time, VAS, effective pressing numbers, side effects and patients general satisfactory degree were recorded. Results: First pressing time and effective pressing numbers showed no significantly difference between two groups. The dosage of morphine significantly higher in the group M than that in the group KM (P0.05). VAS ratings at 4, 8, 12, 24h were all bellow 4, There were no significant difference between two groups. The incidence of nausea and vomiting in the group M was significantly higher than in the group KM (P0.05). No itching was complained in two groups. Conclusion: Ketamine can improve the analgesic effect of morphine, so that decrease the dosage of morphine and the incidence of its side effects.